Creation of NZBS
The Health Reforms introduced in 1992/3 were a significant factor in the development of blood services in New Zealand. The reforms positioned blood services within individual Crown Health Enterprises (CHEs) as they were then known. Competition existed between the CHEs, including their blood services.
In 1996, the Ministry of Health undertook a review of blood services in New Zealand. This resulted in the landmark Carter-Marshall report which indicated a need for change but did not provide a specific blueprint for a national service.
In particular, the following observations were made:
- Widely varying standards in donor management, in processing, and in the use of blood components and blood products;
- Poor national inventory management;
- Lack of a national information system;
- Inefficiencies arising from duplication, comparatively high administrative and transaction costs, and failure to capture potential economies of scale;
- Difficult communication lines at both operational and clinical levels;
- Limited customer focus where customers are seen as donors, clinicians and recipients; and
- Lack of sector wide planning and strategic direction due to fragmentation of the sector.
The Carter-Marshall report recommended the establishment of a national blood service for the following reasons:
- To ensure national consistency of service quality;
- To establish a national strategic direction for the future blood service; and
- To achieve rationalisation of the service process and thereby a more efficient blood service.
In endorsing the recommendation that a national blood service be established, the Ministry of Health identified the following priorities, in descending order of importance:
- To minimise risk to the recipients of blood and blood products;
- To minimise risk to the Crown;
- To be responsive to situations such as emergencies or potential infection risks that threaten the safety of blood and fluctuations in the supply of, or demand for, blood in a proactive manner;
- To provide and ensure clear accountability for blood services;
- To provide strategic direction and leadership;
- To ensure a nationally consistent and accessible service;
- To address identified systems problems;
- To protect the gift status of blood through the stewardship role;
- To drive effective and efficient management of blood services;
- To implement changes in a straightforward manner; and
- To share the broad direction of international trends in blood service management and to take into account overseas failures.
An amendment to the Health Act 1956 was drawn up to allow the establishment of NZBS and to empower it to carry out its responsibilities.
The Health Amendment Act 1998 was passed by Parliament on 1 July 1998.
- NZBS as the appointed entity for all blood in New Zealand;
- NZBS as the steward of all blood for New Zealand, nationally;
- New Zealand's blood service is based on voluntary, unpaid donations;
- NZBS's ability to contract out services where appropriate;
- NZBS's responsibility for all blood from collection to distribution to clinician ('vein-to-vein' for blood), and for other controlled human tissues;
- NZBS as a not-for-profit Crown Health Enterprise (later changed to Hospital and Health Service) and then a statutory corporation with the Ministers of Health and Finance as shareholders; and
- Clear accountability and responsibilities.
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